What Healthcare Executives Aren’t Seeing

The expression used by authors who write about espionage in the Soviet Union concerning the fate of lesser dissidents is, “They were sent to count the birches.”

In other words, they were exiled to Siberia.

In the U.S., perhaps because we have fewer birches, and because we have a more temperate climate, we use a different phrase, especially when an employee fails to meet expectations. The easiest way to fail to meet expectations is to fail to act — unless of course, nobody expects you to act. When asked when their health system is going to address improving access and engagement, some executives reply, ‘someday.’ There are five days in the work week. Someday is not one of the five. Instead of telling the vice president of customer service that he or she is being sent to count the birches, we tell the person that he or she will be given severance pay.

The term severance originated during the French Revolution. More particularly, it refers to the executions of the French ruling class: the guillotine. “Off with their heads,” to tie it to the phrase in Alice in Wonderland. Those whose heads were about to be severed would offer to tip the executioner in the behest that he would sever their head in a single cut.

Severance pay.

In our vernacular, the French term “severance” makes our term severance pay infinitely more benign.

In business, as is also the case in healthcare, with things having to do with information, and information systems, and information security, there are Chief Information Officers: CIOs. Another use of the acronym, when CIOs fall out of favor, is Career Is Over. Those individuals are given severance pay. Had there been CIOs at the time of the French Revolution, their severance pay would have had a more ominous meaning.

Please permit me to share one additional idea tied to a piece of history. In 1862, at Fort Leavenworth, President Lincoln established the first of what would become one of 12 national cemeteries even though Lincoln knew the country still faced several more years of conflict. What makes Lincoln’s action particularly noteworthy to me is that when he established Leavenworth as the first national cemetery, the Union army was losing the Civil War. But losers do not establish national cemeteries. A president presiding over a losing civil war does not set up a national anything unless he has a vision and he truly believes the Union was going to win the war.

Lincoln had a vision and he was confident of winning. People who lack vision and confidence rarely win anything. This holds true in business as well.

There exists a solution today for everything with which healthcare is wrestling. I have yet to meet with a healthcare executive with a vision and the confidence to solve consumerism, access, and engagement. The tools exist.

You can put a stake in the ground today and decide to change how patients and prospective patients interact with your system and participate in their care and wellness.